title: Positive affect in the family environment protects against relapse in first-episode psychosis.
abstract: OBJECTIVE
  To evaluate the contribution of positive affect in the family environment to relapse in first episode psychosis.
  
  
  METHODS
  65 service users with a first episode of psychosis were recruited into the current study along with their key relatives. Relatives were interviewed and rated using the Expressed Emotion (EE) measure of warmth, whilst service users completed questionnaires about the positive and negative affects that they perceived from the family environment. Associations between these measures and relapse were examined in a one-year prospective design.
  
  
  RESULTS
  Service users were less likely to relapse within 6 and 12-month follow-up periods when their relatives were rated high on EE warmth, or when they perceived more positive affect from the family. The relationships between service users' perceived positive affect and relapse were preserved after controlling for baseline symptoms, substance use and employment status. Service users' perceptions of positive affect and EE ratings of warmth appeared to be stronger predictors of relapse outcome than criticism and other EE variables.
  
  
  CONCLUSIONS
  Positive family environments may protect against relapse in first episode psychosis. Psychosocial interventions should aim to foster and maintain positive affect in families during the early stages of illness. Further research is needed to understand the mechanisms linking positive affect and outcomes for people recovering from psychosis.
authors.affiliation: School of Psychological Sciences, University of Manchester, Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK, gejlee@gmail.com.
authors.forename: Gary
authors.initials: G
authors.lastname: Lee
authors.forename: Christine
authors.initials: C
authors.lastname: Barrowclough
authors.forename: Fiona
authors.initials: F
authors.lastname: Lobban
mesh_terms: D000293:Adolescent; D000328:Adult; D000339:Affect; D000368:Aged; D017028:Caregivers / Q000523:psychology; D019260:Expressed Emotion; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011618:Psychotic Disorders / Q000517:prevention & control* / Q000523:psychology*; D055502:Secondary Prevention; D011795:Surveys and Questionnaires; D055815:Young Adult